Individuals holding higher perceptions of cardiovascular disease (CVD) risk are observed to be more likely than those holding lower perceptions of CVD risk to experience a subsequent myocardial infarction, independent of baseline CVD risk factors. We propose to conduct 25-year survival follow-up on a population-representative sample of 1163 adults from the PHHP experimental community and 1279 adults from the control community in order to examine whether the introduction of resources for behavior change (smoking cessation, exercise, diet change) interact with pre-existing health risk beliefs to promote survival. Furthermore, we will examine the degree to which interval change in smoking, diet, exercise and weight management explain the influence on survival among a subset of PHHP participants. Individuals holding higher perceptions of cardiovascular disease (CVD) risk are observed to be more likely than those holding lower perceptions of CVD risk to experience a subsequent myocardial infarction, independent of baseline CVD risk factors. One hypothesis for this association is that these fear-provoking beliefs promote a series of coping behaviors that, in themselves, hasten the occurrence of MI. Given that many emerging technologies (i.e. DNA testing, advanced imaging) will shape beliefs about personal CVD risk, understanding the long-term implications of risk perception is a crucial and timely public health concern. [unreadable] [unreadable] [unreadable] [unreadable]